Drug	G* S**	Same-class substitutions	Alternate-class substitutions
Crestor	S	lovastatin, pravastatin, simvastatin
Diovan	S		1) hydrochlorothiazide, 2) atenolol, nadolol 3) lisinopril, enalapril 4) diltiazem, nifedipine ER, verapamil 5) clonidine, guanfacine
Effexor XR		venlafaxine immediate release	fluoxetine, paroxetine, sertraline
Fosamax	G S		1) estrogen 2) calcium/ vitamin D 3) exercise
Lexapro	S	fluoxetine, paroxetine, sertraline
Lipitor	S	lovastatin, pravastatin, simvastatin
Nexium		omeprazole	1) ranitidine, famotidine 2) OTC antacids
Prevacid		omeprazole	1) ranitidine, famotidine 2) OTC antacids
Protonix		omeprazole	1) ranitidine, famotidine 2) OTC antacids
Singulair			For Asthma: 1) albuterol inhaler 2) beclomethasone inhaler 3) theophylline For Allergies: 1) loratidine, cetirizine, 2) cromolyn sodium nasal spray
Toprol XL	G S	metoprolol immediate release
Vytoin			lovastatin, pravastatin, simvastatin

    *G – generic availability       
  **S – tablet suitable for splitting

                                                                                                                                      Back to Cover Page

     The Expensive Drug Survival Index contains an alphabetical listing of the most popular medications costing more than $30 per month at usual doses. To the right is a sample of the index from How to Save on Prescription Drugs.* Next to each drug is at least one tip that might be used to lower treatment costs. The tips correspond to cost-saving methods (CSMs) 10 through 13 discussed in chapters 5 and 6. Please refer to those chapters for a complete explanation.
     The second column (to the right of the listed drug) contains a “G” when there is a generic equivalent available at a lower price (see Cost-saving Method 10), and an “S” when the listed medication comes in a tablet form that is suitable for splitting as a cost-saving measure (see CSM 13).
     The third column lists cheaper medications from the same family or class (see CSM 11), and the fourth column contains cheaper medications from alternate classes used for the same purpose (see CSM 12). Where more than one class is represented, they are numbered in no particular order. For columns three and four, not all possible substitutions are listed—only a representative few. Suggested substitutions are either less than $30 per month of treatment at usual doses, or they are significantly cheaper than the listed drug.
     Where more than one cost-saving method is provided, all of the methods may not be simultaneously applicable or bring about the same degree of savings. For example, a same-family substitution may be a better value than splitting a very expensive tablet, even though both possibilities are listed.
     The suggested substitutions are not a treatment recommendation for any medical condition. They are simply suggestions that you might discuss with your doctor. No changes in treatment should be made unless under the direct guidance of a treating physician.
     Prices of all of the drugs in this table can be checked easily online. Be sure to bring the cost comparison for any proposed substitution to your doctor for review.

*The complete Expensive Drug Survival Index coud not be reprinted for the website due to copyright issues, but a complete and updated version--including the latest generic availability--is part of the newest edition of How to Save on Prescription Drugs. 

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